Jan. 30--BOISE -- As the debate over Idaho Gov. Butch Otter's proposed state health insurance exchange heats up, a North Idaho senator has sent out a mass email and posted a message on Twitter comparing the role of insurance companies to "the Jews boarding the trains to concentration camps," saying the federal government is using private insurers and in the future will "pull the trigger" on them.

Sen. Sheryl Nuxoll, R-Cottonwood, defends her analogy. "I just want people to hear the truth and to be aware that what is being presented before us is a socialistic program," Nuxoll said Wednesday. "There is no disrespect for any group or people with the analogy. ... I just want people to know the truth."

Nuxoll sent the email out Jan. 23 to more than 120 email addresses, and also posted the message on Twitter.

Senate President Pro-Tem Brent Hill R-Rexburg, said he doesn't fault her. "This is a very emotional issue for a lot of people," Hill said. "There's a lot of 'stuff' going around, a lot of information, a lot of viewpoints being expressed. As we get closer to making that decision, the rhetoric's going to get more dramatic."

He added, "I don't think this is exclusive to Sen. Nuxoll."

The governor's exchange legislation was introduced in a Senate committee on Tuesday. The same day, Otter posted a petition on his official website for Idahoans to sign to urge support for the bill, and encouraged them to contact their legislators. Wayne Hoffman, head of the Idaho Freedom Foundation and a vocal opponent of the bill, posted his own dueling petition the same afternoon, opposing it.

Nuxoll's message, headed, "Another Reason against the State Health Insurance Exchange," said in full, "The insurance companies are creating their own tombs. Much like the Jews boarding the trains to concentration camps, private insurers are used by the feds to put the system in place because the federal government has no way to set up the exchange. Several years from now, the federal government will want nothing to do with private insurance companies. The feds will have a national system of health insurance and they will pull the trigger on the insurance companies."

Another message she posted a week earlier on Twitter said, "The health insurance exchange will be the battle for the legislature this year. It simply is replacing capitalism with socialism."

Nuxoll said she made the analogy because "I felt badly for the Jews -- it wasn't just Jews, but Jews, and Christians, and Catholics, and priests. My thing was they didn't know what was going on. The insurance companies are not realizing what's going to end up in their demise."

Idaho's health insurance industry has been strongly supportive of Otter's move to have a state-based health insurance exchange, rather than defer to a federally run exchange.

"I am shocked by that message," said Marnie Packard, manager of Idaho government relations for PacificSource Health Plans, one of five major Idaho health insurers that are participating in a coalition pushing for a state-based exchange. "I think that some of the terms that she used can be very offensive to a lot of people."

Packard said, "A state-based exchange, it's going to lower the cost, it's keeping the jobs local, keeping the insurance industry and those doing business in the state of Idaho continuing to do business in the state of Idaho. If it's a federal exchange, who knows who's going to be participating in the exchange?"

Opponents have been calling on Otter to refuse to cooperate with the national health care reform law in any way, including by setting up a state-run exchange.

Otter convened a working group that studied the issue for months, before overwhelmingly recommending a state-based exchange. The governor's newly introduced bill calls for the exchange to be a quasi-governmental entity, not a state agency; it would have to be self-supporting and couldn't receive any state tax funds.

Under the national health care reform law, exchanges in each state -- whether state- or federally run -- will serve as an online portal for citizens to shop for health insurance plans and access government subsidies, if they qualify.

Otter, who strongly opposed the national health care reform law, said in a "Call to Action" sent out to Idahoans this week, "Ceding all control to the federal government means giving up any possibility of effectively pursuing local priorities regarding cost containment, quality control, regulatory control, accountability, job formation and a product tailored to our Idaho needs."

Hill said, "When we are emotional about something, sometimes we use hyperbole to get across our point. We need to be careful not to judge one another on the way we say things -- we need to try to understand one another."